Reducing Brain Drain In Medical Practice
It is no longer news that the bill to ensure medical professionals practice for five years before being issued a license has scaled through second reading at the National Assembly, in an effort to curb brain drain in the country. Despite the good intention behind such a bill to ensure there are enough medical practitioners in the country to meet international best practices for medical practitioner-to-patient ratios, it is worrisome how such a bill targets only the practitioners emigrating without due consideration of the reasons behind such movement. As wonderful as it could be to have so many medical professionals in the country to attend to patients, the bill does not address it in the context that would encourage it. This is because various issues compound and frustrate medical professionals, some of whom leave the country for the duration of their study in the country.
Becoming a medical doctor in Nigeria requires six years of rigorous academic training and a mandatory one-year house-manship job and the NYSC, while other health care professions like medical laboratory science, radiography, pharmacy, nursing, require five years of intensive academic and clinical training with a mandatory one-year internship and the NYSC, which may be prolonged than necessary due to some Nigerian factors like the ASUU strike or health workers strike. That being the case, what is the certainty that such a person would secure a job immediately? When would the five years start to count? Would the government make a 5-year job provision for all of them after their mandatory service? Would an individual who stayed for five years before securing a job work another five years to have freedom of emigration?
How about the elongated years of study? At what age would such a fellow retire from a government job? All of these are factors of time that are crucial to any serious-minded fellow. Aside from that, it is worth noting that without a license, an individual is yet unqualified to practise such a profession, and as such, it might not be wrong to say that only trained quacks would be practising within a 5-year period post-graduation without a license, which will also do more harm than good for the health sector. In addition, what happens to the “freedom of movement” (Section 41) and “the right to freedom from discrimination” under (Section 42) as assured by the 1999 Constitution of the Federal Republic of Nigeria (as amended)? All of these may pose more danger than good as it would scare away fresh minds who intend to practise in the health care sector considering the length of times required to actualise such a goal and the infringement of their right to practise at will in any region of their choice.
However, it would also be crucial not to turn a blind eye to issues and circumstances surrounding the emigration of such professionals in the country, such as the inadequate basic infrastructural facility in the health sector, a lack of proper motivation for the health professionals, and pay parity amongst the professionals, amongst other vital circumstances surrounding such. Till this moment, there are lingering issues with the implementation of an increase in the Consolidated Medical Salary Structure (CONMESS) and Consolidated Health Salary Structure (CONHESS) and the payment of Hazard allowances to some health professional interns across the nation. These are some of the worrisome issues that are responsible for such professionals seeking emigration to other places. More so, immigration fosters unity and diversity, confers international collaboration on offering solutions to health care challenges, and ensures research collaboration as well.
Beyond forceful retention of healthcare workers that would even frustrate the patient and quality of care due to a lack of motivation and willingness to practise in such an environment, it is necessary to put in place quality measures that would enable the health care professionals to stay at will and joyfully carry out their duty to improve health care practices. It is important to emphasise that such can only be achieved if a holistic approach to funding and resource allocation to healthcare is guaranteed, subsidised medical education for all medical students in the health sector, a smooth and hitch-free academic journey, adequate compensation and motivation of health workers, employment opportunities for health workers and not selected few professionals, scholarship and funding opportunities for exceptional medical students, and improvement in healthcare infrastructural facilities.
All of these would make our home greener than looking the other way, which in turn would joyfully ensure health care workers’ stay and allow them to practise in satisfaction that would improve quality of care. I therefore implore the policymakers to have a redress of the bill and appeal to relevant stakeholders to ensure that the bill addresses what it intends to address in real time.
By: Abdulrahman Opeyemi
Opeyemi, an online media practitioner, wrote in from Abuja.
Who Is Afraid Of Subsidy Removal?
Within a few hours things changed – some marketers shut their petrol stations, the price of petroleum motor spirit (PMS) tripled; transportation fare, food prices soared. It was just a pronouncement by President Bola Ahmed Tinubu during his inaugural speech that subsidy on petroleum is “gone” and the economy and welfare of many citizens took a worse turn.Nigerians are quick to condemn the insensitivity of the government to the plight of the people but the citizens are not any better. Many Nigerians capitalize on any given opportunity to make “quick” money even at the detriment of their fellow citizens. How their actions will affect their neighbours and other citizens is the least of their worries. Otherwise, how come petroleum marketers who were selling petrol at the official pump price of N195,00 or a little above that raise the price to as high as N600, N800 or even N1000,00, depending on the location and filling station, at the mere mention that petrol subsidy will be removed? Why should taxi drivers, some of whom bought fuel at the official price, hike their fares by almost 300 per cent? How can the traders on hearing the announcement triple the prices of the items stocked in their stalls and shops? The worse is that the Nigerian National Petroleum Company Limited who would have come to the rescue of the populace is also a culprit of the same offence. Quickly after the president’s pronouncement and despite the refutation by the government that Tinubu did not say that subsidy removal will take immediate effect, NNPC filling stations adjusted their fuel pump prices to N511,00 per liter.The Managing Director of the Nigerian National Petroleum Corporation, Mele Kyari, earlier in the week while appealing to Nigerians to stop panic buying of petroleum products, said that there was sufficient supply of petroleum products. One would want to believe that the “surplus” fuel on ground, which apparently is old stock, was subsidised. That being the case, why should the pump price be hiked? What will happen to the excess money realised from this increase?Nigeria is a tough place to live in presently. The disruption the president’s pronouncement has done to the economy, the misery brought to the citizens is unimaginable but Nigerians should not make the situation worse for one another through extortion.
The Governor of Imo State, while addressing newsmen on Wednesday, observed that removal of subsidy was a key point in the manifesto of all the major contenders in the recently held presidential election in the country. He noted that both the candidates of the Peoples Democratic Party (PDP), the All Progressives Party (APC) and Labour Party (LP) promised to remove fuel subsidy if elected president of Nigeria. That is a fact. Nigerians heard them but failed to reject it at that time. We all hailed it believing that subsidy was the root of Nigeria’s economic woes. Do we then not have a share in the calamity that has befallen the country? The few knowledgeable people who cried out that removal of subsidy would do the nation more harm than good were not listened to. I recall a particular public affairs analyst, Majid Dahiru, constantly insisting that the issue of energy security should not be toyed with. According to him, any country that does not have energy security (availability of petrol, diesel, electricity at an affordable price), cannot prosper economically and is bound to have challenges of peace and security. He and his likes also insisted that most developed countries have been able to attain food and energy security through subsidy because if you do not subsidise the prices will go up, the cost of production will rise in addition to other spiral effect on the economy and the well being of the citizens just as it is currently in Nigeria. Unfortunately, Nigerians were meant to believe that subsidy is injurious to the nation’s economy. The people that should know better, told the masses that only the rich were benefiting from fuel subsidy and that it has no impact on the lives of the poor. Some argued that only the people in the cities were gaining from subsidy because those in the rural areas were already buying the product way above the official pump price. Because of the corruption angle of the subsidy over the years, the inflated cost of the imported product and all that, it just felt like removal of subsidy was a blanket approach to cleansing the system.
Today, we know better. We have seen that the consequences of subsidy removal are more on the poor, low-income earners than the rich. In a viral video on the social media, some motorists queued up at an NNPC filling station here in Port Harcourt on hearing the news of the subsidy removal, hoping to get the product at the old, official price but when the gates of the gas station were opened and the new price was unveiled, none of them could drive in. How many rich people are complaining about the effect of the subsidy removal on prices of food stuff, transportation and other things? The President of the Nigeria Labour Congress, Joe Ajero, has been in the news in the past five days, expressing the displeasure of Nigerian workers over the latest development, insisting that Tinubu must take the country back to where it was before May 29 and that if there must be any form of subsidy removal, government must negotiate with the workers, the market men and women and other Nigerians. That is a good step. Nigerians must insist that the government must work. That means, the government must fix the Nigerian refineries. Government must deal with oil theft, insecurity, corruption and other factors responsible for the country not meeting up with her OPEC quota of 2.4million barrels of oil per day. The government must have the political will to deal with corruption which has kept the nation in this sorry state. Otherwise, there is no guarantee that the money that will be saved from subsidy removal, if it must take place, will not be mismanaged. Most importantly, government should start cutting waste by cutting the cost of governance. The president and the state governors can function effectively without the fleet of cars at their disposal. President Tinubu is said to be one of the richest men in Africa. So, it can be argued that his aim of wanting to occupy the topmost position in the country is not to enrich himself. He has seen it all in life. So, he should make a name for himself by prudently managing the resources of the country for the wellbeing of the citizens.
The president should not be adamant on carrying out any plan, policy or decision that is inimical to the wellbeing of the generality of the people. He should have a listening ear and always consult widely in all his dealings as he promised during his inaugural speech. If the fuel subsidy must go, let it be done in such a way that it will be less painful on the poor suffering Nigerians. He should listen to some constructive advice offered by some well-meaning individuals and groups, which include ensuring that our refineries are operational and or at least waiting for Dangote refinery to come on stream to help keep the fuel price from spiraling out of control. There should be a holistic approach to solving our national problem which should include good governance and appointing the qualified, capable hands into offices. The time for political patronage is over. There must be the assemblage of capable Nigerians from different ethnic groups, religions and political parties with a burning desire to save the nation from further sinking. This way, Nigeria’s economy will blossom and there will be enough money to continue to subsidise petrol and other things that will make the life of the citizens more meaningful and Nigeria a country we can all be proud of.
By: Calista Ezeaku
Principle Of Readiness In Development Process
The principle of readiness has to do with the fact that every human being develops and uses personal abilities, qualities and the free will in ways that differ from everybody else. This would mean that no two persons are exactly alike or the same, both in regards to the use and exercise of personal free will, and perception of issues. People differ widely in every respect, right from the date of birth, in every experience of life and how each one ends. But among the principles and laws of development and progression, are some definite obligations which everyone must bear as personal responsibility.
An Encephalocodal law of growth and development stipulates that every human being is the sum of his cumulative thoughts, past and present. As a man thinks, so is he! For purposes of justice and fair judgement, the time of personal responsibility begins in adulthood. Yet, heredity and trails of natural history cling on. There is also a Proximodal law in growth and development process which stipulates that immediate environment of birth or origin does not come by an accident. Everybody is born when and where he most deserves to be born into, as a most appropriate starting point in life’s journey. No injustice or mistake!
Then comes the personal challenges of an individual having to use, develop and modify the cumulative contents of past thoughts which result in present conditions. Both assets and liabilities must be utilised diligently to forge healthier development, by modifying observed lapses and adding nobler values to present assets. Nobody bears the burdens of another; not even parents!
Individuals and groups of people often make the common mistake of comparing themselves with others and wanting to be like some other person, away from their root specifications. What is meant by root-specifications include the badge of natural history, made up of hereditary factors and cumulative thoughts. Everybody wears this invisible badge of our cumulative past, which determine present postings and experiences. Despite individual differences and peculiarities, there is yet another law which bring people of similar characteristics together in close proximities.
Thus in every human engagements we find that, like birds of same feathers, people of similar proclivities and perceptions, come together to pursue shared interests and values. Divisions and hostilities can arise where differences are wide and not managed effectively, especially where monetary inducements play some roles. We must also understand that the differences among individuals and groups do reflect in values and choices which people extol, which others may find unacceptable. There is no art to find the mind’s construction on the face, we are told.
In politics, like other activities which cut into the life-chances of individuals and groups, there is the likelihood of serious conflicts and disagreements arising. Such conflicts and disagreements get worse and sometimes bloody, where money plays most vital role in power-bargaining. An ideal democracy is fired by ideological conviction, whereby individuals make choices and decisions based on personal conviction. But in a political culture where private gains and “stomach infrastructure”, rather than value-based ideologies, drive the polity, violence, fraud and corrupt practices would thrive.
We cannot deny the fact that there is a growing awareness among Nigerians that politics is more of an economic enterprise of a high stake, than an ideology-driven effort to build up a just society. It becomes obvious that genuine development can hardly take place where the divisions, lapses and differences among the people would serve as tools of power exploit. Politics should be about the development of a nation, rather than the hustling for power, which translates into opportunity for primitive accumulation of wealth.
The principle of readiness in development process would mean that those who hustle to acquire power should have acquired the readiness to use power for diligent and effective development purposes. Such development agenda would be a comprehensive system of up building that must go beyond construction of roads and bridges. A large number of Nigerians know that construction projects usually involve the inflation of contract values as well as “commission” or kick-back connected with political contracts. But any development process which misses out what Paulo Freire called Conscientisation, is a failed project.
The concept of conscientisation demands that all development programmes should be designed to bring about a deep-rooted change in peoples’ perceptions, mind-set, attitude and action-patterns towards some positive direction. Late Julius Nyerere of Tanzania stressed that development should be citizen-based, with the encephalocodal law or thought-structuring having strong emphasis. It does not matter the nature of any development project.
Especially for developing countries, grassroots development process should embrace and focus on the Heard, the Heart and the Hands. The head includes the development of intellectual and intuitive faculties; the heart refers to conscientisation or the development of sound empathy and conscience, while development of the hands refers to productive labour. A nation becomes corrupt and the economy unproductive because of deficiencies in development history.
The principle of readiness in development process as it relates to the citizens, includes the fact that the timing of any project or programme should coincide with the ability of the citizens or groups of value, embrace and benefit maximally from it. This is based on an old admonition of not casting pearls before swine. A lot of well-intentioned projects suffer ignominious failures and waste because of wrong timing of when to introduce and implement them. People should not be given what they are not ready to embrace, appreciate and maintain. You can lead a horse to the stream but you can hardly force it to drink.
Arising from the wide variations and disparities among groups of people, it is hardly reasonable or wise to prescribe the same development menu for every group of people. A more vital aspect of development has to do with mind-set, thinking and value orientation. What economists call scales of preference counts a great deal in the application of the principle of readiness in development process? But politics of greed and myopia seeks to offer same diet for everybody, whereby money takes the position of wise choices based on personal conviction as development abhors a vacuum or one-sidedness.
By: Bright Amirize
Dr Amirize is a retired lecturer from the Rivers State University, Port Harcourt.
Roots Of Nigeria’s Predicaments
After the publication of an article titled: Recolonising Nigeria; (The Tide: Wednesday 10, 2023), an anonymous reader sent a test message, saying some pleasant things. The fact that leadership is at the root of the development or underdevelopment of any nation, is not a far-fetched reality. What many Nigerians are not aware of is the truth that there are usually huge interventions by foreign powers in the politics and other critical sectors of this nation’s affairs. How the mechanism of such interventions operates would always remain security secrets. Real politics!
That an imperfect electoral system throws into leadership positions persons who rarely possess the capacity to lead a complex nation like Nigeria, is a truth which any intelligent person can grasp easily. What would remain unknown to many people is the jinxed mechanism of electoral laws that are foisted on developing nations by internal and external powers and interests. Similarly, who the external powers and interests are, will usually remain nebulous. It is obvious that a faulty structure or foundation would hardly produce anything perfect, as an outcome.
Between November 1966 and May 1967, some foreign powers and interests revealed the abundance of oil and gas deposits in Southern Nigeria, whose result was the repudiation of an “Aburi Accord”. Someone asked: “Why did the British Government, with Russia, its cold war enemy, help the Nigerian Government to fight against Biafra?” Wars are fought or sponsored for political and economic purposes, largely. Real politics!
Therefore, the intrigues, conspiracies and diplomatic plots involved in global political economy are issues which average Nigerians know nothing about. Expectedly, the top echelon of a nation’s military and security institutions constitute impregnable and exclusive cult system, where no intruder can be spared. Similarly, under the cover of national security and national interests, a lot of things can be buried permanently and with an immunity that acts with impunity. Thus an aspect of governance known as a cryptocracy, whose operations are shrouded in secrecy, cannot be ignored as a present reality.
When General Colin Powel, late former American Secretary of State, delivered “Tell Magazine Lecture” in Abuja in 2009, he made some statements that were quite revealing. He and late General Sani Abacha were close friends and it became known that late Abacha had some relationship with foreign governments even before he became a military head of state. The Nation newspaper of June 7, 2009, also published an interview with Prof. Taiwo Ogunlade where Nigerians were told that: “Abacha attended a special school, later to be known as School of Assassins” in the United States which prepared him for the task of becoming the nations’ head of state, many years before he eventually made it”.
Late General Sani Abacha was not alone in the list of top Nigerian military and security personnel who attended special courses in foreign countries or had some relationship with foreign powers and interests. We cannot rule out the fact that foreign powers plant those they prepare and choose to occupy critical positions in developing countries, especially mineral-rich countries.
The Central Intelligence Agency of the United States of America may be an old player in the game of national security, but current competitors in that game are getting really smart. In their book: National Security and the American Society, Trager and Simonie, defined national security as “the part of government policy having as its objective the creation of national and international conditions favourable to the protection and extension of vital national values against existing or potential adversaries”. What are the “vital national values” which every nation seeks to protect and extend?
“Stomach infrastructure” is obviously a basic value for several Nigerians, because, that value represents self-preservation and protection of life. For nations, no matter the level of development or underdevelopment, vital national values, would include security and safety from internal and external aggressions or abuses. We cannot deny the fact that a nation’s political-economy accounts for the aggressiveness with which vital national values are protected against existing or potential adversaries. The history of colonialism and other forms of exploitation have been characterised by moving into new frontiers in the search for vital national values. Application and extension of power!
What we call foreign powers and interests are those nations that have developed the capacity and strategies to protect and extend their national values beyond and outside their own geographical territories. A nation is great and powerful largely through political and economic structures that can make other nations depend on them and also inspire some fear. This is where security and military might combine with modern technology and information to create an awesome influence globally.
While developing nations would not be right to blame all their predicaments on foreign powers, there is a need to ask what have kept backward nations at the mercy of powerful foreign nations. Neither can we say that Nigerians are not patriotic, hard-working and honest; but, on the contrary, the flaws in our public institutions have been deliberately put in place, by clever means. It is true that corruption is a serious predicament in Nigeria, but Goodluck Jonathan told us that corruption goes beyond taking bribes or money changing hands. Politics of wit!
There had been the speculations that many Nigerians holding vital national appointments are “screened agents and moles planted by foreign powers and interests”. It is also alleged in some quarters that “none in this country will in the next decade or two, also ascend the presidency if these foreign powers do not know who you are and have not given their approval”. There is also a theory that “Nigerian money-bags”, many of who made their wealth through criminal means and who had deposited such wealth in foreign banks, had some conditions attached to the “safety of their deposits”. It is a form of “plea bargaining” where you are required to give or do something in return for the protection you enjoy.
Apart from sponsorship of certain activities in the country as a pay-back for foreign protection, there are Nigerians who would not defend vital national values, for fear of some back lash from those who keep their secrets secret. At the end of the day, information is power, for those who use it as vital accoutrement for the protection and extension of vital national values. There are Nigerians programmed to undermine their nations interest, for the protection they enjoy. Foreign powers have secret dozziers of many Nigerians.
There is currently a predatory and exploitative global economic order whereby over 80 per cent of available wealth and resources are controlled and enjoyed by less than 20 per cent of powerful nations. The masses can scramble over the crumbs allowed to trickle down to them. Being the custodians and managers of this economic system, powerful nations have the task of ensuring that no developing nation disrupts or destroys this political-economy. What have been the motives and patterns of management of national borrowings? Why are our refineries not functioning? We grow the economy of foreign powers.
By: Bright Amirize
Dr Amirize is a retired lecturer from the Rivers State University, Port Harcourt.
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